I’ve Turned My Back on Roe to Fight for Abortion Equity


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As we mark one year since the Supreme Court overturned Roe v. Wade, the effects of that decision can’t be overstated. Over the last year, those needing abortions, pregnancy care, and their providers have been unconscionably harmed. And now, in order to move forward, we must look back and acknowledge how trying to save Roe became a fool’s errand. Until those who support abortion rights reckon with the compromises that the Roe framework created and stop white-washing history, we’ll never build a just and equitable future. We—and I include myself in this group—need to name and own how a white supremacist culture led to a generation of policies that guaranteed the legal right, but not an equitable right, to abortion.

I started my career in the late 1980s—a time when white feminism loomed large—working for abortion rights attorneys. By 1992, I was managing media and editing briefs with Kathryn Kolbert, the lawyer set to argue Planned Parenthood v. Casey, a case thought to be the end of Roe. Roe’s original framework only allowed abortion bans after “viability,” with largely meaningless exceptions. But after Casey, abortion could be restricted throughout a person’s pregnancy, and states were given a green light to pass more bans, so long as they didn’t create so-called “undue burdens” on those seeking abortions. Together, these two cases formed the legal framework on which abortion rights rested for nearly 50 years.

In the three decades that followed Casey, states enacted hundreds of restrictions that effectively banned abortion for many, all while Roe ‘remained the law of the land.’”

Watching Casey play out, realizing our opposition will never rest, and understanding the power of state and local policies radicalized my abortion advocacy. At the time, we came up with a key quote for Kolbert to describe the ramifications of Casey, explaining that the case had created “a hole in Roe big enough to drive a Mack truck through,” because the “undue burden” standard was vague and subjective. In the three decades that followed Casey, states enacted hundreds of restrictions that effectively banned abortion for many, all while Roe “remained the law of the land.” It was the slow bleed to the Supreme Court case that finally overturned Roe a year ago.

You see, Roe was a response—arguably a revolutionary one for its time—to a reality in which abortion bans were killing and maiming those who needed to terminate their pregnancies. Casey was a response to an era of incrementalism, designed to effectively ban abortion without explicitly doing so.

protester holds a placard saying "reproductive justice is

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Meanwhile, the white feminist movement put a disproportionate emphasis on the legal framework while the Democratic party rested on Roe’s laurels. Collectively, we celebrated moderate gains that failed to keep pace with the unrelenting anti-abortion opposition. To make matters worse, by this point, one of the earliest “compromises” of the Roe era—the 1977 Hyde Amendment, which banned Medicaid coverage of abortion—had already disproportionately blocked access for people working to make ends meet, often people of color and women who were forced to navigate racist and discriminatory systems.

Throughout these decades, elected allies content with Roe failed to repeal the Hyde Amendment; remained comfortable with burdening young people with parental or judicial consent for abortions; seemed unmoved that those needing later abortions often couldn’t get care; disregarded those traveling long distances multiple times to access a clinic; and failed to see the dangers of criminalization looming.

If you identify with these impacted communities, Roe stopped guaranteeing you access long ago. And in the aftermath of Roe being overturned, these same communities have continued to be disproportionately harmed.

Now is the time to follow those with marginalized experiences so we don’t repeat history.”

BIPOC leaders in the reproductive justice movement have long made clear that Roe-era laws were a compromise. Yet the powerful institutions with the largest megaphones led by white women largely carried on, selling the Roe framework—riddled with holes—without having the tough conversations about what and who got left behind. Now is the time to follow those with marginalized experiences so we don’t repeat history. Now is the time to go on offense and forge a path that creates equity and justice in abortion care and guarantees everyone the freedom to control our bodies, lives, and futures.

At the National Institute for Reproductive Health, the first national organization in this field dedicated to advancing proactive state and local policies, we’ve been pushing for solutions that refuse to accept the limits of Roe. It’s taken more than a decade of advocacy, and now a monumental loss, to see the kind of forward motion we truly need. Since Roe was overturned, state and local leaders in all political environments invested more in new reproductive health care programs, including abortion, than ever before—nearly $208 million across the country. That’s a more than three-fold increase in a single year, compared to the three years combined before Roe fell.

activists holding abortion rights signs

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Wins worth fighting for can’t be erected quickly from the rubble of Roe. It will take long-term investments and a willingness to look beyond conventional political wisdom and familiar talking points. But what’s clear is we don’t have to, and we must not, settle for only a return to the Roe status quo.

In 2023, there is more evidence than ever that the legal framework of the Roe era was a centrist political compromise that carved out marginalized communities. It tried to address the harms that occurred before the digital age, medication abortion, the growth of robust advocacy organizations and clinical providers, and overwhelming public support for abortion. And Roe was no match for an extreme opposition that kept stripping away access, one group at a time.

It’s on us to demand a framework that includes everyone, no matter their zip code, age, race, identity, or socioeconomic status.”

Today, we can and must reach for modern-day solutions that reflect the here and now: We live in a time when people can safely self-manage abortions on their own terms; the network of abortion funds and practical support organizations is expanding exponentially to help navigate people to care; and our collective work to share abortion stories that shatter shame and stigma have moved the needle on public opinion, which shows overwhelming support for meaningful abortion access that goes beyond hollowed-out rights.

During this week’s milestone—one year after Roe was overturned—I’m offering a cautionary tale to supporters of reproductive freedom: the compromises we make will never satisfy anti-abortion operatives. As allies, our task is to reclaim baseline expectations for what is right and just. It’s on us to demand a framework that includes everyone, no matter their zip code, age, race, identity, or socioeconomic status. Despite its promise, Roe ultimately failed to do that. So it’s time to move on and work toward a bolder vision for our futures.

Headshot of Andrea Miller

Andrea Miller is the president of the National Institute for Reproductive Health (NIRH) and its Action Fund, a policy and advocacy organization that fights for just and equitable access to reproductive health care in states and cities nationwide. A nationally recognized expert in reproductive health, rights, and justice, Andrea’s leadership in this field spans four decades across legal, advocacy, and policy spheres. Before taking the helm at NIRH a decade ago, she led Reproductive Equity Now (formerly NARAL Pro-Choice Massachusetts) after providing strategic consulting to a host of non-profit and philanthropic organizations in the wake of helping to found and serving in the leadership of the Center for Reproductive Rights. Andrea has a Master of Public Administration from the Kennedy School of Government at Harvard University and a Bachelor of Arts in political science from Columbia College, Columbia University.

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